Screening with Papanicolaou tests in Alberta: Are we Choosing Wisely?

OBJECTIVE: To describe the prevalence and geographic distribution of cervical cancer screening, as well as the age groups of those undergoing screening, in Alberta, and to determine if screening practices conform to current guidelines and follow Choosing Wisely Canada recommendations.
DESIGN: Descriptive study using data from the Alberta Ministry of Health Analytics and Performance Reporting Branch.
SETTING: Alberta. PARTICIPANTS: Women who had 1 or more Papanicolaou tests between 2011 and 2013. MAIN OUTCOME MEASURES: Number of women aged 15 to 20 and those aged 70 and older who had 1 or more Pap tests in a 3-year period; year-to-year trends in screening rates for women in these 2 age groups; trends in screening rates in various geographic regions (ie, cities and zones) in Alberta; and the discipline of clinicians who ordered the Pap tests.
RESULTS: Between 2011 and 2013, 805 632 women in the province of Alberta had 1 or more Pap tests for cervical cancer screening. Overall, 25 511 (17.5%) women aged 15 to 20 and 16 818 (10.3%) aged 70 and older were screened contrary to most existing guidelines. Screening rates varied markedly in different geographic regions of the province. Most Pap tests were ordered by family physicians or general practitioners.
CONCLUSION: Within the geographic regions of Alberta, provincial, national, and international guidelines for screening with Pap tests are inconsistently followed. This strongly echoes the need for clinicians and patients to consider the Choosing Wisely Canada recommendations and current guidelines for cervical cancer screening. Copyright© the College of Family Physicians of Canada.